Preoperative N-terminal pro-B-type natriuretic peptide concertation and prognosis of brain tumor patients: a 5-year follow up study

Abstract

Increased N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration predicts poor prognosis of non-CNS cancer patients. We evaluated the association of NT-proBNP concentration with disease severity, discharge outcomes and prognosis of patients undergoing craniotomy for brain tumor. From January, 2010 until September, 2011 two-hundred and forty-five patients (age 55.05 ± 14.62 years) admitted for brain tumor surgery were evaluated for NT-proBNP serum concentration. Outcome at hospital discharge was evaluated with the Glasgow Outcome Scale (GOS). Most common diagnoses were meningioma (37%) and high-grade glioma (20%). Greater NT-proBNP concentration was associated with lower Barthel index (rho = −0.305, p = 0.001) and Mini Mental State Examination scores (rho = −0.314, p = 0.001) and with greater Hospital Anxiety and Depression scale Depression score (rho = 0.240, p = 0.026). Greater admission NT-proBNP concentration was associated with lower discharge GOS score after adjusting for patient age, gender and histological brain tumor diagnosis (β = −0.253, p < 0.001). Greater NT-proBNP concentration was also associated with greater 5-year mortality risk (HR = 1.845; 95%CI [1.166–2.920], p = 0.009) controlling for patient age, gender, history of cardiovascular disease, histological diagnosis and adjuvant therapy. In sum, greater pre-operative NT-proBNP concentration is associated with worse health status, unfavorable discharge outcome and shorter survival of brain tumor patients.

Clinical and Biological Correlates of Preoperative Cognitive Functioning of Glioma and Meningioma Patients

“…Indeed, in our sample, nearly one-third of meningioma patients and 22% of glioma patients presented with cardiovascular comorbidity. In line with previous findings, we found that cardiovascular comorbidity and older age were related to greater NT-proBNP concentrations [25,26], suggesting that NT-proBNP can be a valuable biomarker of underlying cardiovascular function impairment of BT patients. However, Ruggieri et al [18] in a sample of 108 BT patients found no association between increase in NT-proBNP and cardiac dysfunction; levels of NT-proBNP were directly associated with cerebral damage.…”

“…To our knowledge, only one previous study investigated the relationship between levels of NT-proBNP and cognitive functioning of BT patients. Bunevicius et al found that greater NT-proBNP serum concentrations correlated with general cognitive decline in a mixed sample of BT patients [25]; however, this association was not adjusted for potential cofounders. Similarly, in a sample of stroke patient levels, NT-proBNP at admission was associated with worse cognitive functioning in univariate analysis, but the relationship became nonsignificant when the model was adjusted for age, stroke type, and other clinical variables [34].…”

“…Greater serum NT-proBNP concentrations were previously implicated in worse general cognitive functioning and increased risk of cognitive impairment [26,27], decreased perception speed [28], and executive function [29] in community-dwelling adults and in cardiac patients. It was recently shown in BT patients that elevated NT-proBNP levels are associated with a greater five years mortality risk and greater global cognitive decline [25]. Therefore, the possible association between NT-proBNP and cognitive impairment of BT patients warrants further research.…”

“…NT-proBNP is produced by cardiac myocytes in response to volume overload and is used for diagnosis and monitoring of heart failure patients [25]. Greater serum NT-proBNP concentrations were previously implicated in worse general cognitive functioning and increased risk of cognitive impairment [26,27], decreased perception speed [28], and executive function [29] in community-dwelling adults and in cardiac patients.…”

Difficult-to-control secondary hypertension in a patient with history of glioblastoma, and cerebral edema — a case study

“…1). The possible reason for elevated B-type NP include: comorbid heart failure (HFpEF), chronic kidney disease, central nervous system malignancy itself, and/or hypertensive encephalopathy [16][17][18][19].…”